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Introduction

When Elisha arrived, he went alone into the room and saw the boy lying dead on the bed. He closed the door and prayed to the Lord. Then he lay down on the boy, placing his mouth, eyes and hands on the boy’s mouth, eyes and hands. As he lay stretched out over the boy, the boy’s body started to get warm—the boy sneezed seven times and then opened his eyes.

Definition of the emergency

The GP must be available and organised to cope with the medically defined emergency when it comes. Emergency care outside the hospital represents one of the most interesting and rewarding areas of medical practice. City doctors will have to modify their degree of availability, equipment and skills according to paramedical emergency services, while others, especially remote doctors, will need total expertise and equipment to provide optimal circumstances to save their patients’ lives.

In dealing with a specific emergency, the doctor adopts a different approach. Instead of taking a history and performing an examination in the usual way, he or she replaces this with a technique of rapid assessment and immediate management. In fact, the diagnosis may be possible on the information available over the telephone.

An important yet obvious concept is that of ‘time criticality’, which implies that certain patients are at high risk of a critical outcome of deterioration if there is significant delay in appropriate management. This applies particularly to acute coronary syndromes.